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目的探讨医源性母亲因素剖宫取胎终止中期妊娠的相关危险因素。方法收集2000年8月至2008年10月8年间在中山大学附属博济医院和广州市重症孕产妇救治中心收治的医源性母亲因素终止中期妊娠患者134例资料,其中剖宫取胎患者68例,经阴道引产66例。结果医源性母亲因素终止中期妊娠的引产指征前3位为:子痫前期重度94例(70.1%)、器质性心脏病16例(11.9%)、肾炎和(或)肾衰8例(6.0%)。剖宫取胎手术指征前3位为急性心衰(28例)、胎盘早剥(16例)、高血压危象(10例);剖宫取胎组心衰、胎盘早剥、肺水肿的发生率显著高于阴道引产组(P<0.05)。结论胎盘早剥、心衰和肺水肿是医源性母亲因素中期妊娠剖宫取胎的主要高危因素,剖宫取胎术是危重症孕妇终止中期妊娠一个值得选择的分娩方式。
Objective To investigate the related risk factors of cesarean termination due to iatrogenic maternal factors. Methods A total of 134 patients with metaphase pregnancy were enrolled from August 2000 to October 2008 in Boji Hospital Affiliated to Sun Yat-sen University and Guangzhou Center of Severe Maternal and Child Health Center. Among them, 68 Cases, vaginal induction of labor in 66 cases. Results The first three cases of induction of labor induced by iatrogenic mothers were as follows: severe preeclampsia 94 cases (70.1%), organic heart disease 16 cases (11.9%), nephritis and / or renal failure 8 cases (6.0%). In the cesarean section, the first three cases were acute heart failure (28 cases), placental abruption (16 cases) and hypertensive crisis (10 cases). Cesarean section fetus heart failure, placental abruption, pulmonary edema The incidence was significantly higher than vaginal induction of labor group (P <0.05). Conclusions The placental abruption, heart failure and pulmonary edema are the main risk factors for cesarean section fetus with iatrogenic maternal factors. Caesarean section fetus fetus is a worthwhile choice of mode of delivery for pregnant women with critical illness.